scholarly journals Association of serum choline levels and all-cause mortality risk in adults with hypertension: a nested case–control study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Mengmeng Song ◽  
Benjamin P. Xu ◽  
Qiongyue Liang ◽  
Yaping Wei ◽  
Yun Song ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Case Control Study ◽  
Multivariate Logistic Regression Analysis ◽  
Case Control ◽  
High Risk Population ◽  
Chinese Adults ◽  
Baseline Serum ◽  
All Cause Mortality ◽  
Nested Case Control ◽  
Control Study

Abstract Background Serum choline levels were associated with multiple chronic diseases. However, the association between serum choline and all-cause mortality in Chinese adults with hypertension remains unclear. The purpose of this study is to explore the association between serum choline concentrations and all-cause mortality risk in Chinese adults with hypertension, a high-risk population. Methods A nested, case–control study was conducted that included 279 patients with all-cause death, and 279 matched, living controls, derived from the China Stroke Primary Prevention Trial (CSPPT). Baseline serum choline concentrations were measured by liquid chromatography with tandem quadrupole mass spectrometry (LC–MS/MS). Multivariate logistic regression analysis was used to assess the association of serum choline levels and all-cause mortality risk, with adjustment of pertinent covariables, including folic acid and homocysteine. Results The median age of all participants was 64.13 years [interquartile range (IQR), 57.33–70.59 years]. The median serum choline concentration for cases (9.51 μg/mL) was higher than that in controls (7.80 μg/mL) (P = 0.009). When serum choline concentration was assessed as a continuous variable (per SD increased), there was a positive relation between serum choline levels and all-cause mortality risk [odds ratios (OR), 1.29; 95% confidence intervals (95%CI), 1.06–1.57; P = 0.010]. There was an increased all-cause mortality risk for participants in quartiles 2–4 (≥ 4.00 μg/mL; OR, 1.79; 95%CI, 1.15–2.78 compared with quartile 1 (< 4.00 μg/mL). In addition, non-drinking was found to promote the incidence of all-cause mortality for those with high choline concentrations. Conclusions High serum choline concentrations were associated with increased all-cause mortality risk among Chinese adults with hypertension, compared to lower choline concentrations. Trial registration clinicaltrials.gov Identifier: NCT007948885; UTL: https://clinicaltrials.gov/ct2/show/NCT00794885?term=NCT00794885&draw=2&rank=1.

scholarly journals Association of cystatin C levels with metabolic syndrome incidence: a nested case-control study with propensity score matching

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098631
Author(s):  
Tengfei Yang ◽  
Dongmei Pei
Keyword(s):  
Metabolic Syndrome ◽  
Propensity Score ◽  
Physical Examination ◽  
Propensity Score Matching ◽  
Case Control Study ◽  
Case Control ◽  
Chinese Adults ◽  
Biochemical Profiles ◽  
Nested Case Control ◽  
Control Study

Objective Metabolic syndrome (MetS) involves multiple metabolic disorders and seriously affects human health. Identification of key biological factors associated with MetS incidence is therefore important. We explored the association between MetS and the biochemical profiles of Chinese adults in Shenyang City in a nested case-control study. Methods We included adult participants who underwent physical examination at our hospital for 2 consecutive years. Participants’ biochemical profiles and other MetS components were tested and monitored continuously. Propensity score matching was used to adjust confounding factors between participants with and without MetS. We analyzed the association between incidence of MetS and the biochemical profiles of participants. Results Of 5702 participants who underwent physical examination between 1 January 2017 and 1 December 2018, 538 had confirmed newly developed MetS. After successfully matching 436 pairs of participants, mean cystatin C (Cys-C) level was significantly higher in the MetS group than in the non-MetS group. Logistic regression analysis indicated that age (years) and γ-glutamate transpeptidase, creatinine, uric acid, and Cys-C levels were significantly associated with MetS incidence; among these, the odds ratio of Cys-C was highest (3.03; 95% confidence interval, 1.02–9.00). Conclusions Cys-C levels were significantly associated with the incidence of MetS among Chinese adults.

scholarly journals Barriers to Adherence to Antimicrobial Stewardship Postprescription Review and Feedback For Broad-Spectrum Antimicrobial Agents: A Nested Case-Control Study

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Akane Takamatsu ◽  
Kenta Yao ◽  
Shutaro Murakami ◽  
Yasuaki Tagashira ◽  
Shinya Hasegawa ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Case Control Study ◽  
Tertiary Care ◽  
Previous History ◽  
Multivariate Logistic Regression Analysis ◽  
Case Control ◽  
Factors Associated ◽  
Nested Case Control ◽  
Control Study

Abstract Background Postprescription review and feedback (PPRF) is one of the most common strategies in antimicrobial stewardship program (ASP) intervention. However, disagreements between the prescribers and ASP personnel can occur. The aim of the present study was to identify the factors associated with nonadherence to PPRF intervention. Methods The present retrospective nested case-control study was performed at a tertiary care center, which has been conducting a once-weekly PPRF for carbapenems and piperacillin/tazobactam since 2014. Nonadherence to ASP recommendations was defined as the failure of the primary care team to modify or stop antimicrobial therapy 72 hours after the issuance of PPRF recommendations. Factors associated with nonadherence to PPRF intervention were identified using multivariate logistic regression analysis. Results In total, 2466 instances of PPRF in 1714 cases between April 2014 and September 2019 were found. The nonadherence rate was 5.9%, and 44 cases were found in which carbapenems or piperacillin/tazobactam continued to be used against PPRF recommendations. Factors associated with nonadherence to PPRF recommendations were a previous history of hospitalization within 90 days (adjusted odds ratio [aOR], 2.62; 95% confidence interval [CI], 1.18–5.81) and a rapidly fatal McCabe score at the time of PPRF intervention (aOR, 2.87; 95% CI, 1.18–6.98). A review of the narrative comments in the electronic medical records indicated that common reasons for nonadherence were “the patient was sick” (n = 12; 27.3%) and “the antimicrobial seemed to be clinically effective” (n = 9; 20.5%). Conclusions Nonadherence to PPRF recommendations was relatively uncommon at the study institution. However, patients with a severe disease condition frequently continued to receive broad-spectrum antimicrobials against PPRF recommendations. Understanding physicians’ cognitive process in nonadherence to ASP recommendations and ASP interventions targeting medical subspecialties caring for severely ill patients is needed to improve ASP.

scholarly journals Serum selenium level and cancer risk: a nested case-control study

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Steven A. Narod ◽  
Tomasz Huzarski ◽  
Anna Jakubowska ◽  
Jacek Gronwald ◽  
Cezary Cybulski ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Case Control Study ◽  
Case Control ◽  
Serum Selenium ◽  
Baseline Serum ◽  
Increased Risk ◽  
Low Selenium ◽  
Nested Case Control ◽  
Risk Of Cancer ◽  
Control Study

Abstract Background Epidemiologic studies have demonstrated a relationship between selenium status and cancer risk among those with low selenium levels. It is of interest to prospectively evaluate the relationship between selenium and cancer among women who reside in a region with ubiquitously low selenium levels. Methods We performed a nested case-control study of baseline serum selenium levels and cancer risk using data and biological samples from 19,573 females that were participants in a biobanking initiative between 2010 and 2014 in Szczecin Poland. Cases included women with any incident cancer (n = 97) and controls (n = 184) were women with no cancer at baseline or follow-up. Serum selenium was quantified using mass spectroscopy. Results The odds ratio associated being below the cutoff of 70.0 μg/L compared to a level above 70.0 μg/L was 2.29 (95% CI 1.26–4.19; P = 0.007). The risks for women in the two middle categories were similar and suggests that the normal range be between 70 μg/L and 90 μg/L. There was evidence for an increased risk of cancer among women in the highest category of selenium levels (i.e., > 90 μg/L), but this association did not achieve statistical significance (OR = 1.63; 95%CI 0.63–4.19; P = 0.31). Conclusions Results from this study suggest that suggest that the optimum serum level of selenium in women living in Poland should be between 70 μg/L and 90 μg/L.

scholarly journals Enhancing-ARDS diagnostics for ICU patients: a retrospective, nested case-control study to develop a biomarker-based model

2021 ◽  
Author(s):  
Xuan Fu ◽  
Jinle Lin ◽  
Samuel Seery ◽  
Wuyuan Tao ◽  
Yanxiu Lu ◽  
...  
Keyword(s):  
Case Control Study ◽  
Vital Signs ◽  
Multivariate Logistic Regression Analysis ◽  
High Mobility ◽  
Diagnostic Value ◽  
Case Control ◽  
Cell Protein ◽  
Surfactant Protein D ◽  
Nested Case Control ◽  
Control Study

Abstract Background: To investigate whether a series of biomarkers including club cell protein 16 (CC16), angiopoietin 2(Ang-2), soluble receptor for advanced glycation end-products (sRAGE), high-mobility group box 1 protein (HMGB1), and surfactant protein D (SPD) could be utilized for identifying patients, thereby increasing the diagnostic value of acute respiratory distress syndrome(ARDS) in intensive care unit (ICU). Methods: 211 ICU admissions were enrolled in this retrospective, nested case-control study. These patients were then divided into ARDS (n=79) and non-ARDS (n=132) groups according to the Berlin criteria on ICU day 1. Patient characteristics, vital signs, and laboratory examinations were collected within three hours of admission. Five inflammatory associated plasma biomarkers, as well as lung epithelial and endothelial injury which included CC16, Ang-2, sRAGE, HMGB1 and SPD were measured in the morning of day two in the ICU. Diagnostic values were analyzed with receiver operating characteristic (ROC) curves. Pearson’s product-moment correlation coefficient and multivariate logistic regression analysis were applied for predictive purposes. Results: C-reactive protein (CRP), NT-proBNP, and PH values for traditional indicators and five biomarkers were analyzed with an objective ARDS indicator, the PaO2/FiO2 ratio. Evidence suggests that only four of potential indicators analyzed here, and CRP hold high diagnostic value. The area under curve (AUC) for each were as follows: CC16 (AUC: 0.752; 95%CI0.680-0.824), Ang-2 (AUC: 0.695; 95%CI 0.620 -0.770), HMGB1 (AUC: 0.668; 95%CI 0.592-0.744), sRAGE (AUC: 0.665; 95%CI 0.588-0.743), CRP (AUC: 0.701; 95%CI 0.627-0.776). No single indicator surpassed the diagnostic capability of the PaO2/FiO2 ratio which had an AUC: 0.844(95%CI 0.789-0.898), especially in terms of sensitivity. However, when the binary logistic model was transformed and the model was built, the AUC increased from 0.647(95%CI 0.568-0.726) to 0.911(95%CI 0.864-0.946). Among the combinations tested, PaO2/FiO2+CRP+Ang-2+CC16+HMGB1 resulted in an AUC of 0.910 (95%CI 0.863-0.945), while PaO2/FiO2+CRP+Ang-2+CC16+HMGB1+sRAGE+SPD have an AUC of 0.911(95%CI 0.864-0.946). Conclusions: A combination of the assessed biomarkers could enhance ARDS diagnostics, which has obvious ramifications for patient care and prognosis. It may be possible to develop a predictive ARDS nomogram; however, of the combinations tested here, we would recommend PaO2/FiO2+CRP+Ang-2+CC16+HMGB1 for clinical practice. This is because of the cost implications in contrast with the benefit involved in utilizing the more elaborate model. Although, further health economics research is required to consider this opportunity cost for emergency care policy.

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